11D1001895 CLIA NUMBER - SOUTHEAST LUNG AND CRITICAL CARE SPECIALISTS

Laboratory Demographics

CLIA Number: 11D1001895

Facility Name: SOUTHEAST LUNG AND CRITICAL CARE SPECIALISTS

Facility Address:
340 HODGSON COURT STE #2
SAVANNAH, GA
ZIP 31406
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Facility Phone Number: 912 354-6614

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1972788081

Taxonomy: 261QS1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1001895
LAB Type	Physician Office
Facility Name	SOUTHEAST LUNG AND CRITICAL CARE SPECIALISTS
Street	340 HODGSON COURT STE #2
City	SAVANNAH
State	GA
ZIP	31406
Phone	912 354-6614
CertificateType	4
CertificateEffectiveDate	7/23/2022
CertificateExpirationDate	7/22/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024